OPENING her post in January this year Elisia White, 28, wasn’t ready for the shock and anger she felt when she read a letter from the NHS.
The mum-of-two, who lives with her partner in Oldham, Manchester, had been hit with a fine by the NHS Business Authority Service (NHSBSA) for what she thought was a free prescription.
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Under NHS rules, pregnant women must receive a maternity exemption certificate in order to get free medication.
But expectant and new mums have told The Sun their midwives failed to apply for the document or made errors when applying.
Elisia is one of 30,624 women who received penalty charge notice (PCN) in 2022 due to the red tape, The Sun can reveal.
In the past six months, nearly 40,000 new mums received “threatening” letters questioning their right to free medicine, with more than 80% going on to receive a penalty charge notice.
Elisia, a carer and mum to Rory, two, and Abel, eight months, said: “I thought it was some promotional material or a hospital appointment reminder.
“I wasn’t expecting a demand to pay a £100 fine for getting prescriptions while I was pregnant, something I know I was entitled to for free.”
“I thought because I was pregnant and gave birth to a baby, I was correct in ticking the maternity exemption box on the back of the pharmacy script to get the medication I needed for free. Boy was I wrong,” recalls Elisia.
Elisia, who gave birth to Abel in September last year, regularly asked her midwife for her maternity exemption form when she first fell pregnant but was told “not to panic” and that it would be sorted out.
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In June, Elisia wasn’t feeling well and blood tests revealed she needed pregnancy supplements of iron and B12.
“My midwife told me to get the script filled and she’d get an exemption form out to me,” she said.
“It was obvious I was pregnant when I went to collect the script. The pharmacy assistant told me to tick the pregnancy exemption box.
Then seven months later in January 2022, Elisia received the £100 fine letter and a request to pay the £9.25 prescription fee.
“I was incredibly anxious. A fine for what I thought was free medicine on top of the cost of living crisis,” she said.
Elisia was made redundant at 30 weeks pregnant with her first child.
When her second child was born in September 2022, she was not on standard maternity allowance making the fine notification even more worrying.
“My only income is a carer’s allowance of less than a hundred pounds a week,” she said.
“I had no spare cash to pay the fine.
‘I received a fine after a miscarried my baby’
Some of the fines sent out to new mums totalled hundreds of pounds due to them having more scripts.
Meanwhile, letters have been issued to women who miscarried too.
Education program manager Kara Kiernan, 38, was horrified when she received a fine of £90 for a free maternity supplement after she tragically miscarried her baby.
Kara, from Leighton Buzzard, told The Sun she felt like the NHS is hitting her with a hidden “miscarriage tax” and wants new mums or women who have lost babies to know they can appeal the fines.
“When I opened my NHSBSA letter in January I felt like I’d been gut punched,” Kara said.
“The horror of not one, but two miscarriages came flooding back and on top of that a government body was asking me to fork out a fine and a prescription charge totalling nearly £100 for the experience of not becoming a mum.”
Kara first discovered she was five weeks pregnant in August 2022.
She said: “At 38 it was a shock because we’d been told I couldn’t conceive.”
Due to Kara’s high risk category, she was given a scan and had the chance to get the first scan image of her much longed for baby.
“Blood tests showed I needed folic acid and iron. When I went to collect the script the pharmacy assistant asked if I was pregnant,” she said.
“I told her I was seven weeks gone and she told me to tick the maternity exemption box on the back of the script to get the medication free.
“Tragically the next week I miscarried our much-wanted baby.”
Kara then fell pregnant again in October and again lost the baby in the first two months.
To then get the fine and demand to pay for the prescription in January left her “shattered”.
However, Kara was determined not to pay the fine.
She said: “I appealed and was told I had to prove I was pregnant.
“I was only in the very early stages of pregnancy.
“My midwife had not been assigned and I didn’t even know about the exemption form.
“Midwives normally are assigned towards the end of the first trimester and until then pregnant women are on their own when it comes to getting the exemption.”
Instead, she had to go through her records and send in images of the pregnancy scans and doctors’ notes to prove she had been pregnant and had lost the baby.
Kara said: “Looking at them again hit me with another wave of hurt and loss.
“I was eventually told the NHS Business Service would waive the fine, but I’d still have to pay for the script and send them £9.25 despite proving I had been pregnant.
“It’s tragic and ridiculous. The system needs to be better.”
When you claim a free NHS prescription, the NHSBSA checks to see if you were exempt from paying.
If no exemption is found, it sends an enquiry letter asking you to confirm your eligibility or to contact them to discuss your case.
If you weren’t exempt from paying for prescriptions, or if you don’t respond, a penalty charge notice (PCN) is then issued.
A spokesperson added: “On behalf of NHS England, the NHSBSA investigates a random sample of prescription forms from patients who have claimed exemption from payment to verify the accuracy of the exemption declared.
“This is done monthly after the form is submitted to the NHSBSA by pharmacies for payment.
“We encourage all patients to check they are eligible before claiming free prescriptions.”
How to appeal the fine
The NHS Business Service takes up to eight months to send out the fines, which can cause unwanted stress for women who have suffered miscarriages or new mums struggling financially.
Elisia and Kara are now urging any women who get the fines to appeal them.
Kara recommended immediately lodging a reconsideration request and phoning or writing in with documents proving your pregnancy status.
“Stand your ground and appeal the decision,” Kara said.
“Don’t forget to check the time limit for paying the fine and ensure that is extended if you have appealed.”
“Time limits vary so contact the service and ask what is needed and how long you have to reply and appeal.
“It’s critical you read the letter carefully and highlight any deadlines or key information you can’t understand or have to meet,” explained Elisia.
She said: “I want all mums to ensure they get the maternity exemption form the day they discover they are pregnant to stop them having to go through what I have experienced.”
The NHSBSA’s brief is to crack down on prescription fraud, but it has been accused of penalising patients who acted in good faith.
In 2019, a parliamentary select committee concluded that the penalty charge process is a “heavy-handed rush to judgment”.
Meanwhile, the Business Services Authority claims it is hamstrung by regulations that state that exemptions can’t be backdated by more than a month, even if a patient can prove her pregnancy dates.
Who’s eligible for help with NHS costs?
Depending on your circumstances, you could get help to pay for:
- NHS prescriptions
- NHS dental treatment
- Sight tests, glasses and contact lenses
- Travel to receive NHS treatment
- NHS wigs and fabric supports
If you’re pregnant or have given birth in the last 12 months, you are entitled to free NHS dental treatment and free NHS prescriptions.
The latter applies as long as you have a valid maternity exemption certificate.
For more information on rights and rules, check out the NHSBSA website.
